From the Guidelines
Children under 2 years of age should avoid added sugars entirely, while those over 2 years old should limit their daily intake to less than 25 grams (about 6 teaspoons) per day. This recommendation is based on the most recent and highest quality evidence from the American Heart Association (AHA) 1, which suggests that children should consume ≤25 g (100 kcal or ≈6 teaspoons) of added sugars per day, and added sugars should be avoided for children <2 years of age.
Key Considerations
- The World Health Organisation (WHO) also recommends that intake of free sugars should not exceed 10 % of total energy intake (strong recommendation) and should be less than 5 % of total energy intake (conditional recommendation) 1.
- The European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) Committee on Nutrition suggests that intakes of free sugars should be reduced in children and adolescents (2–18 years) with a desirable upper limit of less than 5 % energy intake and should be even lower in those younger than 2 years 1.
- When introducing sugars, it is essential to focus on naturally occurring sugars found in fruits, vegetables, and dairy products before adding processed sugars to a child's diet, as early taste preferences develop during the first years of life, and limiting sugar exposure helps establish healthier eating patterns.
Potential Risks
- Excessive sugar consumption in childhood has been linked to dental cavities, unhealthy weight gain, and increased risk of chronic conditions like type 2 diabetes and heart disease later in life.
- Added sugars provide calories without essential nutrients, potentially displacing more nutritious foods in a child's diet.
Implementation
- Start with minimal amounts and avoid sugar-sweetened beverages entirely if possible.
- Make treats containing added sugar occasional rather than daily offerings.
From the Research
Age of Introduction to Added Sugar
- The American Heart Association recommends delaying the introduction of added sugar until age 2 2.
- A study found that about 25% of children were given added sugar at or before 7 months, with contributing factors including caregivers' race/ethnicity, education, employment, weight status, parity, child sex, and premature birth 2.
- The World Health Organization, American Heart Association, and the 2015 USDA dietary recommendations propose guidelines for added sugar intake to reduce risk for disease, but these guidelines are not easily understood or translated to children 3.
Recommendations for Added Sugar Intake
- The European Society for Paediatric Gastroenterology, Hepatology and Nutrition Committee on Nutrition recommends that intake of free sugars should be reduced and minimised with a desirable goal of <5% energy intake in children and adolescents aged ≥2 to 18 years 4.
- The American Heart Association recommends a fixed value of 25 g of added sugar for all children 2-19 years of age, but this approach does not take into account the different levels of intake across this wide age range 3.
- A study proposed a simplified approach to recommend added sugars based on daily energy needs of children 2-19 years, deriving simple regression equations to predict grams or teaspoons of added sugars per day based on age 3.
Health Effects of Added Sugar
- Excess sugar intake increases risk for obesity and related comorbidities among children 3, 5.
- High sugar intakes are associated with chronic diseases including cardiovascular diseases, asthma, elevated blood pressure, and overweight 2.
- Sugar-containing beverages/free sugars increase the risk for overweight/obesity and dental caries, can result in poor nutrient supply and reduced dietary diversity, and may be associated with increased risk of type 2 diabetes mellitus, cardiovascular risk, and other health effects 4.